Healthcare Provider Details

I. General information

NPI: 1558634576
Provider Name (Legal Business Name): BRIDGET A LECHE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2012
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 MAGNOLIA ST
HOUMA LA
70360-6304
US

IV. Provider business mailing address

420 MAGNOLIA ST
HOUMA LA
70360-6304
US

V. Phone/Fax

Practice location:
  • Phone: 985-879-3966
  • Fax: 985-872-4473
Mailing address:
  • Phone: 985-879-3966
  • Fax: 985-872-4473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5806
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number5806
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: